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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2005 October;164(5):391-94

language: English

Radiotherapy after chemotherapy in locally advanced non-small cell lung cancer: a really chance?

Odantini R. 1, Bellia S. 1, Marchione A. 1, Malara S. 1, Calipari N. 1, Al Sayyad S. 1, Sceni G. 2, Ruggeri R. 2, Naccarato S. 2, Capua A. 1

1 Department of Radiotherapy, University of Reggio Calabria, Reggio Calabria, Italy;
2 Department of Medical Physics, University of Reggio Calabria, Reggio Calabria, Italy


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Aim. The use of radiotherapy after chemotherapy in locally advanced non-small cell lung cancer (NSCLC).
Methods. From January 1998 to June 2001, 135 patients with NSCLC and residual disease after chemotherapy were accrued. Clinical staging before chemotherapy was: 69 III/B, 60 III/A (N2) and 6 relapse after surgery. Mean cycles of chemotherapy were 6 and the outcomes were 3 complete response (CR) and, after relapsed, 48 partial response >50% (PR1), 51 partial response <50% (PR2), 27 no change (NC), 9 local progression disease (PD). The mean radiotherapy dose was 60.5 Gy (range 45-70 Gy); 115 patients had a dose >60 Gy. The planning was with a CT in 103 patients, our PTV=GTV+1 cm, regional lymph nodes were treated whether involvement. We valued the outcomes 1 month after with CT.
Results. We had 0 CR, 27 PR1, 48 PR2, 41 NC, 19 PD (local progression or distant metastasis). At 6 months after radiotherapy we had 29/116 stable disease (SD), 37 PD (local), 31 metastases and 19 PD+metastases.
Conclusion. The chemotherapy as a neoadjuvant treatment in NSCLC causes a no-responder disease to following standard radiotherapy: 27/135 CR+PR1 (20%), with 0/135 CR. Moreover only 29/116 had a minimal stable disease in the follow-up and besides all patients made at least 4 cycles of chemotherapy we had 60/116 metastasis in the follow-up. Our conclusion is that in NSCLC, after neoadjuvant chemotherapy, the standard radiotherapy is a useless and time-expended treatment.

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